Interventional Pain Medicine最新文献

{"title":"The relationship of PROMIS physical function scores and healthcare resource utilization in patients treated for chronic low back pain","authors":"Andre Hejazi , Connor Willis , Xiangyang Ye , Jim Youssef , Chip Moebus , Ben Goss , Bryan Cornwall , Darrel Brodke , Zachary L. McCormick , Kenneth Schaecher , Diana Brixner","doi":"10.1016/j.inpm.2024.100522","DOIUrl":"10.1016/j.inpm.2024.100522","url":null,"abstract":"<div><h3>Background context</h3><div>Patients with mechanical chronic lower back pain (CLBP) have few durable treatment options for their condition and thus suffer decreased productivity and have higher healthcare resource utilization (HRU) compared to patients without CLBP. The economic burden of treatment and ongoing care for CLBP is considerable, with healthcare spending in 2016 estimated at $134.5 billion in the United States.</div></div><div><h3>Purpose</h3><div>This study aims to assess the correlation between patient-reported physical function scores and HRU in patients treated for mechanical CLBP.</div></div><div><h3>Study design</h3><div>This was a retrospective cohort study within a university-based health system.</div></div><div><h3>Patient sample</h3><div>Patients with a diagnosis of mechanical CLBP from 2015 through 2020 (index date) who were non-surgical candidates at baseline were included in this study. To ensure the presence of <em>chronic</em> low back pain, patients were required to have encounters between 6 and 12 months as well as between 12 and 24 months following the date of CLBP diagnosis.</div></div><div><h3>Outcome measures</h3><div>Collected data variables included patient baseline characteristics, Patient-Reported Outcomes Measurement Information System - Physical Function (PROMIS-PF) scores, pharmacologic and non-pharmacologic therapies, HRU, and healthcare charges between January 2015 through December 2022.</div></div><div><h3>Methods</h3><div>PROMIS-PF scores were converted to numerical categories ranging from 0 to 3, with Category 0 representing the lowest physical function and Category 3 the highest physical function. Patients were more broadly stratified into Low Physical Function (Low-PF) (Category 0–1) or High-Physical Function(High-PF) (Category 2–3) cohorts. HRU was compared between the Low-PF and High-PF cohorts using linear regression analyses. A mixed-effects regression analysis comparing Low-PF and High-PF patients was performed to model the relationship between patient-reported physical function and healthcare charges. The model is able to estimate charges for a base-case patient and can be adjusted to include patient-specific characteristics.</div></div><div><h3>Results</h3><div>A total of 2765 patients were included in this study, mean age was 50.1 (SD:17.7) years old, 23.6 % were 65 years or older, 68.4 % were female, and 85.3 % were white. Median healthcare charges by PROMIS-PF categories for Year-1 were highest for Category 0 patients ($14,028 [IQR: $5190-38,289]) and lowest for Category 3 ($5352 [IQR: $2417-14,470]). Patients in the Low-PF cohort showed significantly higher rates of all-cause, inpatient stays, outpatient visits, and emergency department (ED) visits compared to High-PF patients. The mixed effects regression model estimated cumulative healthcare charges to be > 2-fold higher for a base-case patient in the Low-PF cohort compared to High-PF. A small portion of patients (n = 14) fail","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"3 4","pages":"Article 100522"},"PeriodicalIF":0.0,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142662513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effectiveness of sacral lateral branch radiofrequency neurotomy for posterior sacroiliac joint complex pain in patients selected by dual sacral lateral branch blocks; A real-world cohort study","authors":"Austin Boos ,&nbsp;Amanda Cooper ,&nbsp;Brook Martin ,&nbsp;Robert Burnham ,&nbsp;Allison Glinka Przybysz ,&nbsp;Aaron M. Conger ,&nbsp;Zachary L. McCormick ,&nbsp;Taylor R. Burnham","doi":"10.1016/j.inpm.2024.100442","DOIUrl":"10.1016/j.inpm.2024.100442","url":null,"abstract":"<div><h3>Background</h3><div>Previous study of spinal neurotomy procedures indicates that stringent block selection improves outcomes. However, this pattern is not established for sacral lateral branch radiofrequency neurotomy (SLBRFN). Few SLBRFN studies have used stringent block selection criteria such as ≥80 % pain reduction following dual sacral lateral branch blocks (SLBB).</div></div><div><h3>Objective</h3><div>Evaluate the effectiveness of SLBRFN in patients with ≥80 % pain relief following dual SLBBs.</div></div><div><h3>Methods</h3><div>Retrospective single-arm cohort study of consecutive patients from two Canadian musculoskeletal and pain clinics who underwent first-time SLBRFN after report of ≥80 % pain relief following dual diagnostic SLBBs. Patients were identified by electronic medical record query between 2016 and 2022. The primary outcome was the proportion of individuals with a ≥50 % reduction in the numeric pain rating scale (NPRS) score three months after SLBRFN. Secondary outcomes included the proportion of responders achieving the minimal clinically important difference (MCID) on the pain disability quality-of-life questionnaire (PDQQ), and the duration and mean percentage of pain relief among those with recurrent symptoms after a successful SLBRFN.</div></div><div><h3>Results</h3><div>Of the 70 participants included, 32 (45.7 %; 95 % CI = 34.6–57.3) reported a ≥50 % reduction in NPRS, and 35 (50.0 %; 95 % CI = 38.6–61.4) achieved the MCID on the PDQQ at 3-months. Among the 17 patients who reported a return of symptoms, the mean duration of relief was 8.0 ± 3.5 months, and the mean percentage of pain relief was 77.9 % ± 16.4 %. Logistic regression models revealed that the use of multi-tined RF probes and lower patient BMI were associated with treatment success.</div></div><div><h3>Discussion/conclusion</h3><div>SLBRFN reduced pain and disability in approximately 50 % of patients at 3 months when selected using relatively restrictive selection criteria. Treatment success was associated with multi-tined RF probe type and lower patient BMI. Larger prospective studies assessing long-term outcomes are needed to further evaluate the impact of different selection criteria and techniques on SLBRFN effectiveness.</div></div>","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"3 4","pages":"Article 100442"},"PeriodicalIF":0.0,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142555645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"C0-C1 joint injection: Anatomical, clinical and technical review","authors":"Christopher Mares ,&nbsp;Carl Majdalani","doi":"10.1016/j.inpm.2024.100443","DOIUrl":"10.1016/j.inpm.2024.100443","url":null,"abstract":"<div><h3>Background</h3><div>Cervicogenic headaches (CGH) are proven clinical entities. The prevalence of CGH arising from the atlanto-occipital (AO) joint is unknown. The best evidence for treatment of CGH is for third occipital nerve radiofrequency neurotomy. Treatment of CGH includes intra-articular injections into upper cervical spine joints.</div></div><div><h3>Objective</h3><div>To perform a review of the anatomy and clinical presentation of AO joint (AOJ) pain referral as well as a technical description to safely access the AOJ.</div></div><div><h3>Methods</h3><div>A literature review was performed to explore the intricacies of the cranio-cervical junction (CCJ) with a focus on the relation between the AOJ and vascular anatomy. Our technical approach is described with complementary images.</div></div><div><h3>Results</h3><div>The AOJ lies anterior to a venous sinus and slightly superior to the horizontally oriented vertebral artery crossing the joint line.</div></div><div><h3>Conclusion</h3><div>The authors propose a modified superior needle trajectory that seeks to avoid these vascular structures and to access the AOJ safely.</div></div>","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"3 4","pages":"Article 100443"},"PeriodicalIF":0.0,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142529552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Key anatomical and clinical points about the superior cluneal nerves","authors":"Thomas Fichtner Bendtsen,&nbsp;Siska Bjørn,&nbsp;Thomas Dahl Nielsen","doi":"10.1016/j.inpm.2024.100445","DOIUrl":"10.1016/j.inpm.2024.100445","url":null,"abstract":"","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"3 4","pages":"Article 100445"},"PeriodicalIF":0.0,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142529550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factfinders for patient safety: Epidural steroid injection in patients with lumbar spinal stenosis","authors":"George Christolias ,&nbsp;Aditya Raghunandan ,&nbsp;Byron J. Schneider ,&nbsp;Kunj Amin ,&nbsp;David Hao ,&nbsp;Jaymin Patel ,&nbsp;International Pain and Spine Intervention Society's Patient Safety Committee","doi":"10.1016/j.inpm.2024.100444","DOIUrl":"10.1016/j.inpm.2024.100444","url":null,"abstract":"<div><div>This FactFinder presents a brief summary of the evidence suggesting that epidural steroid injections can be safely performed even in the setting of severe, multilevel lumbar spinal stenosis.</div></div>","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"3 4","pages":"Article 100444"},"PeriodicalIF":0.0,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142529551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial review of the validation of thoracolumbar injury classification and severity score in the management of acute and subacute osteoporotic vertebral compression fractures","authors":"Alexander R. Vaccaro","doi":"10.1016/j.inpm.2024.100441","DOIUrl":"10.1016/j.inpm.2024.100441","url":null,"abstract":"","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"3 4","pages":"Article 100441"},"PeriodicalIF":0.0,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142433249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative abdominal wall Botulinum A toxin in the outpatient pain clinic prior to complex abdominal wall repair: A letter to the editor","authors":"Kimberly Youngren,&nbsp;Armando Alvarez,&nbsp;Mikayleigh Pearson,&nbsp;Sarah E. Billmeier,&nbsp;Marissa Mendez,&nbsp;Brent White","doi":"10.1016/j.inpm.2024.100440","DOIUrl":"10.1016/j.inpm.2024.100440","url":null,"abstract":"","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"3 4","pages":"Article 100440"},"PeriodicalIF":0.0,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142417624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the editor: The use of XperGuide® needle guidance software for CT guided thoracic sympathetic block","authors":"Christiaan SJ. Hammerstein ,&nbsp;Sjoerd Servaas ,&nbsp;Erik GJ. Vermeulen ,&nbsp;Oscar BHAM. van Haagen","doi":"10.1016/j.inpm.2024.100439","DOIUrl":"10.1016/j.inpm.2024.100439","url":null,"abstract":"<div><p>With the introduction of modern cone beam computed tomography in the operating room, the benefits of imaging modalities in daily practice are recognized by an increasing number of clinicians. Newer generation imaging modalities include CT needle guidance software, which can aid the operator place the needle correctly during percutaneous intervention. This technique has several advantages over traditional percutaneous interventions, especially for high risk procedures like thoracic sympathectomy.</p><p>We describe and discuss outcomes and possible advantages of applying CT guided needle placement using needle guidance software (XperGuide®) for percutaneous thoracic sympathetic blockade in 8 patients. Based on our findings, we conclude that the use of high quality imaging and needle guidance software such as XperGuide® may improve patient outcomes, and reduce the risk of adverse effects, providing a relatively easy, safe, and valuable alternative treatment strategy for thoracic sympathectomies.</p></div>","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"3 4","pages":"Article 100439"},"PeriodicalIF":0.0,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772594424000608/pdfft?md5=e887c9f33fa32c5811bbb43b8c7553c5&pid=1-s2.0-S2772594424000608-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142270672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of thoracolumbar injury classification and Severity Score in the management of acute and subacute Osteoporotic vertebral compression fractures – A pilot study and a suggested modification","authors":"Jatinder S. Gill ,&nbsp;Martina Stippler ,&nbsp;Qing Ruan ,&nbsp;Nasir Hussain ,&nbsp;Andrew P. White ,&nbsp;Vwaire Oruhurhu ,&nbsp;Obaid Malik ,&nbsp;Thomas Simopoulos ,&nbsp;Ivan Urits ,&nbsp;Ryan S. D'Souza ,&nbsp;Sanjeet Narang ,&nbsp;Joshua A. Hirsch","doi":"10.1016/j.inpm.2024.100438","DOIUrl":"10.1016/j.inpm.2024.100438","url":null,"abstract":"<div><h3>Objective</h3><p>To retrospectively assess the Thoracolumbar Injury Classification and Severity Score (TLICS) in patients with osteoporotic vertebral compression fractures (OVCF) and compare the treatment given with that predicted by the TLICS score.</p></div><div><h3>Methods</h3><p>All medical records of patients presenting from January 2014 to November 2017 for acute atraumatic or low impact OVCF were screened, and eligible patients were retrospectively reviewed. The TLICS score was determined based upon magnetic resonance imaging (MRI) findings and clinical records. Clinical records (including pain score data), imaging data, operative procedures, and stability of neurological examination were tracked over three months for each patient.</p></div><div><h3>Results</h3><p>Of the 56 patients included, 36 patients had a TLICS score of 1, 18 had a TLICS score of 2, and two had a TLICS score of 4. Only one patient with a TLICS score of 4 underwent surgical stabilization, while the rest of the cohort was managed non-operatively, with or without kyphoplasty. TLICS score 1 corresponded to simple compression and TLICS score 2 corresponded to burst morphology with retropulsion and without neurological deficits. Of the patients with a TLICS score of 1 and 2 who underwent kyphoplasty, there was a statistically significant improvement in pain scores in both groups; however no significant difference was observed, between each TLICS score (i.e., 1 or 2). None of the patients developed instability or neurological decline.</p></div><div><h3>Conclusion</h3><p>TLICS score correctly predicted operative versus non-operative management in all patients with OVCF. TLICS may be used in making management decisions, and in the triage of these patients for operative versus non-operative evaluations. Our study suggests that patients with TLICS score of 4 or higher require surgical evaluation, while those with TLICS of 1 or 2 are likely to have satisfactory non-surgical management with augmentation or conservative care. In general, patients with OVCF typically present with low TLICS score. Kyphoplasty appears to be similarly beneficial in patients with a TLICS score of 1 or a TLICS score of 2. A modification of the TLICS score by adding TLICS Zero to include uncompressed OVCF with edema is suggested. The limitations of this study include a small size; a larger study is needed to confirm these findings.</p></div>","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"3 3","pages":"Article 100438"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772594424000591/pdfft?md5=b3fa2b819ef7085c2d1f78d37506e340&pid=1-s2.0-S2772594424000591-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142164558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Superior Cluneal neuralgia—An underappreciated cause of low back pain?","authors":"Einar Ottestad,&nbsp;Anthony Machi","doi":"10.1016/j.inpm.2024.100436","DOIUrl":"10.1016/j.inpm.2024.100436","url":null,"abstract":"","PeriodicalId":100727,"journal":{"name":"Interventional Pain Medicine","volume":"3 3","pages":"Article 100436"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772594424000578/pdfft?md5=94d891c4e85067ea9fe697c006efeff3&pid=1-s2.0-S2772594424000578-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142239143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}